BMC Anesthesiology最新文献

{"title":"Effects of intravenous morphine and lidocaine on bacterial growth.","authors":"Cristiana Iulia Osoian, Stanca Lucia Pandrea, Mirela Flonta, Adrian Florea, Luminita Matros, Daniela Ionescu","doi":"10.1186/s12871-025-03070-6","DOIUrl":"https://doi.org/10.1186/s12871-025-03070-6","url":null,"abstract":"<p><strong>Background: </strong>Infection prevention and control remain critical challenges in the ICU. Morphine, a frequently used opioid for postoperative pain management, may indirectly promote infections, whereas lidocaine might have protective effects. However, data regarding the direct influence of morphine and lidocaine, at concentrations within the range of plasma concentrations, on common ICU bacterial strains are lacking. This is the first study to investigate the direct effects of morphine and lidocaine at plasma concentrations corresponding to possible clinical settings, as seen in multimodal analgesia regimens, on bacterial growth using microbiological assays and transmission electron microscopy.</p><p><strong>Methods: </strong>Morphine (1000 ng/ml, 2000 ng/ml) and lidocaine (4 µg/ml, 10 µg/ml) were placed in contact with standard strains of Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus and tested using diffusion method, broth dilution method, and time-kill assay. Additionally, E. coli, P. aeruginosa and S. aureus were exposed to lidocaine 10 µg/ml and examined via transmission electron microscopy.</p><p><strong>Results: </strong>Morphine and lidocaine exhibited neither stimulatory nor inhibitory effects on bacterial growth, regardless of concentration, volume, or exposure time in microbiological testing. In contrast, transmission electron microscopy revealed that lidocaine exposure altered bacterial ultrastructure, causing significant cell wall disorganization and rupture, alterations in cytoplasmic and nucleolar structure, and the appearance of \"ghost cells\", indicative of cell lysis.</p><p><strong>Conclusions: </strong>At plasma concentrations, morphine and lidocaine do not directly affect bacterial growth in vitro microbiological laboratory testing. Lidocaine on the other hand, in higher plasma concentrations, disrupts bacterial ultrastructure. Further studies are needed to investigate the significance and clinical impact of these findings.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"190"},"PeriodicalIF":2.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy and safety of nalbuphine and hydromorphone in painless colonoscopy techniques: a randomized controlled trial.","authors":"Chunliu Hou, Siming Zhang, Yuqing Zhu, Guochun Wen, Guoran Wang, Jinxiang Dai, Fei Xu, Chunjie Li, Huiyi Chen, Di Wang, Qingqing Han, Xuesen Su, Wenjie Zhang, Shouyuan Tian, Yan Li","doi":"10.1186/s12871-025-03038-6","DOIUrl":"https://doi.org/10.1186/s12871-025-03038-6","url":null,"abstract":"<p><strong>Background: </strong>Colonoscopy is essential for diagnosing colon lesions but is often associated with discomfort. Painless colonoscopy techniques are being increasingly used to improve the patient experience.\"However, in the case of painless colonoscopy, anesthesia is performed outside the operating room, which requires more significant peri-examination of hemodynamic changes and adverse postoperative reactions. This requires a more careful selection of narcotic analgesics, and there needs to be optimal analgesic drug guidance in clinical practice. This study compared the efficacy and safety of nalbuphine and hydromorphone in improving patient comfort and maintaining hemodynamic stability during elective colonoscopy.</p><p><strong>Methods: </strong>This prospective, randomized, double-blinded controlled trial included 72 adult patients (aged 18-65) who underwent sedation colonoscopy. The 72 patients were randomly divided into two groups using a computer-generated random sequence. Body mass index 18.5-28.0 kg/m2; American Society of Anesthesiologists (ASA) grade I to II. Then, the nalbuphine group was given 0.13 mg/kg nalbuphine, the hydromorphone group was given 0.016 mg/kg hydromorphone, and during the operation, 10-20 mg/time propofol could be appropriately injected according to the patient's examination and cooperation. All patients were continuously monitored for oxygen saturation, heart rate, and noninvasive mean arterial blood pressure. The colonoscopy time and anesthesia time were recorded. Adverse reactions such as hypotension, decreased oxygen saturation, nausea, and vomiting were recorded. Anesthesiologist satisfaction, gastroenterologist (operator), and patient satisfaction were recorded.</p><p><strong>Results: </strong>Both nalbuphine and hydromorphone effectively maintained hemodynamic stability, with no significant differences in vital signs observed between the groups (P > 0.05). However, nalbuphine significantly reduced the incidence of postoperative nausea, vomiting, dizziness, and headache compared to hydromorphone (P < 0.05). The reduced side effects of nalbuphine were marked, suggesting a better postoperative comfort profile.</p><p><strong>Conclusions: </strong>While nalbuphine and hydromorphone effectively maintain intraoperative vital signs, nalbuphine offers superior postoperative comfort. This makes nalbuphine a preferable analgesic choice in outpatient colonoscopy settings. Further research is warranted to determine the optimal dosages for both drugs and to explore their mechanisms of action in procedural pain management.</p><p><strong>Register number: </strong>ChiCTR2300077446,November 9, 2023.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"187"},"PeriodicalIF":2.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for administration of additional neuromuscular block reversal in adults undergoing general anaesthesia: a single centre retrospective case-control study.","authors":"Susan R Vishneski, Amit K Saha, Lan C Tran, Rohesh J Fernando, Suneeta K Acharya, Lisa K Lee, Leah B Templeton, Amber K Brooks, L Daniela Smith, T Wesley Templeton","doi":"10.1186/s12871-025-03009-x","DOIUrl":"https://doi.org/10.1186/s12871-025-03009-x","url":null,"abstract":"<p><strong>Background: </strong>Residual neuromuscular block continues to be a modifiable risk factor for major postoperative pulmonary complications in adults.</p><p><strong>Methods: </strong>We performed a large retrospective case-control study at a single center to evaluate both the prevalence and risk factors for clinically significant residual neuromuscular block following reversal with neostigmine.</p><p><strong>Results: </strong>We found that clinically significant residual neuromuscular block after reversal with neostigmine is rare, occurring in 3.2% of adults. Risk factors for incomplete reversal with neostigmine following rocuronium administration included: increasing age, ASA physical class status III and IV, a cumulative dose of rocuronium > 0.43 mg•kg^-1hr^-1, an interval of < 48 min between the last dose of rocuronium and neostigmine administration, a qualitative train-of-four count < 2 at the time of reversal with neostigmine, emergency case status, thoracic surgery, and African American race.</p><p><strong>Conclusion: </strong>Reversing neuromuscular block with sugammadex in patients at higher risk of incomplete reversal with neostigmine can improve outcomes and reduce costs, especially in cases where qualitative assessment is utilized or when quantitative monitoring is unavailable.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"189"},"PeriodicalIF":2.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Post-pericardiectomy ECMO for constrictive pericarditis: a case series and literature review.","authors":"Bin Jia, Shujie Yan, Yong Luo, Jian Cheng, Jie Cheng, Junjie Fei, Yushuang Gao, Xiao Liao, Luyu Bian, Jian Wang, Yuan Teng, Gang Liu, Lanying Gao, Bingyang Ji","doi":"10.1186/s12871-025-03063-5","DOIUrl":"https://doi.org/10.1186/s12871-025-03063-5","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"191"},"PeriodicalIF":2.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthesia management for patients with Prader-Willi syndrome undergoing bariatric surgery: a single-center retrospective case series study.","authors":"Juan Tan, Haibei Liu, Huawu Yang, Dan Luo, Qiang Fu, Qiang Li","doi":"10.1186/s12871-025-03013-1","DOIUrl":"https://doi.org/10.1186/s12871-025-03013-1","url":null,"abstract":"<p><strong>Background: </strong>Prader-Willi syndrome (PWS) is a rare neurodevelopmental disorder resulting from abnormalities on chromosome 15q11.2-q13. These genetic anomalies pose significant challenges in anesthetic management when PWS patients undergo bariatric surgery.</p><p><strong>Methods: </strong>We present five instances of anesthetic management in three PWS patients who underwent bariatric surgery under general anesthesia supplemented with nerve block techniques.</p><p><strong>Results: </strong>Obesity, sleep apnea, airway ventilatory dysfunction, and hypotonia were the primary challenges faced by PWS patients in our study. We implemented specific strategies, primarily including the reverse Trendelenburg position, gradually deepening sedation, multimodal analgesia and perioperative progressive respiratory exercises. Only in case 1a, respiratory obstruction occurred during mask ventilation, which was resolved through the use of a nasopharyngeal ventilation tract. Additionally, delayed awakening was observed in case 1a postoperatively, with the spontaneous breathing showing minimal recovery following the administration of neostigmine and atropine. Extubation of the tracheal tube was performed on the first postoperative day. Upon her second admission (case 1b), we administered sugammadex as the neuromuscular blockade reversal agent, which facilitated successful tracheal extubation ten minutes post-procedure.</p><p><strong>Conclusions: </strong>We advocate the use of sugammadex as the neuromuscular blockade reversal agent, the implementation of neuromuscular monitoring, progressive respiratory exercises, and multimodal analgesia in PWS patients undergoing bariatric surgery.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"188"},"PeriodicalIF":2.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining pain management: investigating the efficacy and safety of erector spinae plane block and oblique subcostal transversus abdominis plane block in laparoscopic cholecystectomy - a meta analysis of randomized controlled trials.","authors":"Syed Zia Saleem, Syed Muhammad Muneeb Akhtar, Areeba Fareed, Afsana Ansari Shaik, Muhammad Sohaib Asghar","doi":"10.1186/s12871-025-03059-1","DOIUrl":"https://doi.org/10.1186/s12871-025-03059-1","url":null,"abstract":"<p><strong>Background: </strong>Pain following laparoscopic cholecystectomy plays a pivotal role in determining the quality of patient recovery. Considering the opioid crisis, exploration of alternative approaches, such as regional blocks, including erector spinae plane block (ESPB) and oblique subcostal transversus abdominis plane block (OSTAPB), has garnered considerable attention due to their promising outcomes in clinical trials.</p><p><strong>Objective: </strong>Our aim is to provide a robust analysis which reflects the most current evidence for the effectiveness and safety of ESPB by comparing it to OSTAPB in adult patients undergoing laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>An extensive search was performed in the PubMed, Medline, and Cochrane Library databases from inception to June 1st 2023. Mean difference (SMD), and 95% confidence intervals (CIs) were calculated for continuous outcomes, Risk ratios (RR) were calculated for dichotomous outcomes. All statistical analyses were performed using R Statistical Software and meta package v4.17-0.</p><p><strong>Results: </strong>A total of 5 RCTs including 372 participants were included in this meta-analysis. Pooled analysis of overall postoperative pain scores at 12 and 24 h showed ESPB to be superior to OSTAPB [MD = -0.67; 95% CI: (-0.95 to -0.39); p < 0.001, I² = 72%]. ESPB also showed significantly lesser opioid consumption at 24 h postoperatively [MD = -5.36; 95% CI: (-8.56 to -2.15); p < 0.001, I² = 96%], while intraoperative opioid consumption {MD = -0.46; 95% CI: (-1.27 to -0.36); p = 0.27, I² = 0%} and postoperative nausea and vomiting were not significantly different between the two groups {RR = 0.40, 95% CI (0.10 to 1.56), p = 0.19; I² = 56%}.</p><p><strong>Conclusion: </strong>In summary, the erector spinae plane block (ESPB) appears to be the preferred option for acute postoperative pain and opioid reduction in adults undergoing laparoscopic cholecystectomy.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"182"},"PeriodicalIF":2.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of bilateral rectus sheath and oblique subcostal transversus abdominis plane blocks on mechanical power in patients undergoing laparoscopic cholecystectomy surgery: a randomized controlled trial.","authors":"Esma Karaarslan, Yasin Tire, Mahmut Sami Tutar, Nuran Akıncı, Hasan Alp Mermer, Sami Uyar, Dilek Ateş, Gürcan Şimşek, Betül Kozanhan","doi":"10.1186/s12871-025-03062-6","DOIUrl":"https://doi.org/10.1186/s12871-025-03062-6","url":null,"abstract":"<p><strong>Background: </strong>In this study, we aimed to investigate the effects of bilateral rectus sheath blocks (RSBs) and oblique subcostal transversus abdominis plane (OSTAP) blocks on mechanical power (MP) in patients receiving laparoscopic cholecystectomy under general anesthesia. Additionally, we sought to evaluate the impact of these blocks on postoperative pain and quality of patient recovery.</p><p><strong>Methods: </strong>In this prospective, double-blind study, 66 patients who underwent laparoscopic cholecystectomy were randomized into two groups: Group C (control), which received a standard analgesic intravenous regimen; and Group B (block), which received bilateral RSB and OSTAP blocks. Intraoperative mechanical power was measured for all patients. Postoperative pain was assessed using visual analog scale (VAS) scores, and recovery quality was measured using the 15-item quality of recovery (QoR-15) questionnaire.</p><p><strong>Results: </strong>The mechanical power values for patients in Group C were consistently greater at all measured times: baseline, before bridion, and after bridion. Although the difference at baseline was not statistically significant, significant differences were observed before and after bridion (p values = 0.112, 0.021, and 0.003, respectively). Patients in Group B exhibited significantly lower VAS scores at all time points (30 min, 2 h, 8 h, and 24 h) (p < 0.05). Additionally, essential variations were noted in the administration of rescue analgesia between the groups (p < 0.001). Regarding tramadol consumption, Group C patients had significantly greater values [84 (74-156) vs. 0 (0-75), median (25-75th percentiles)] (p < 0.001). For the QoR-15 scores, Group C also had significantly greater values [129 (124-133) vs. 122 (115-125), median (25-75th percentiles)] (p < 0.001).</p><p><strong>Conclusions: </strong>Bilateral RSB and OSTAP blocks significantly reduce mechanical power during surgery. Moreover, they significantly decrease postoperative pain and analgesic consumption and increase patient recovery scores.</p><p><strong>Trial registration: </strong>The study protocol was registered in the international database ClinicalTrials.gov (registration no. NCT06202040). This study was conducted between December 2023 and January 2024 at the Department of Anesthesiology and Reanimation of Konya City Hospital.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"186"},"PeriodicalIF":2.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of rhomboid intercostal nerve, serratus anterior plane, and paravertebral block on the quality of recovery after breast cancer surgery: a randomized controlled clinical trial.","authors":"Jiali Yu, Yi Qi, Yiwei Shen, Dan Wang, Jingyu Xiao, Qi Chen, Ran An","doi":"10.1186/s12871-025-03049-3","DOIUrl":"https://doi.org/10.1186/s12871-025-03049-3","url":null,"abstract":"<p><strong>Background: </strong>Nerve blocks are one of the most important methods of postoperative analgesia in breast cancer surgery. We used a randomized controlled clinical trial to compare the effects of rhomboid intercostal nerve block, serratus anterior plane block, and paravertebral block on the quality of recovery and postoperative analgesia in modified radical mastectomy.</p><p><strong>Methods: </strong>We used a randomized controlled clinical trial to compare the effects of rhomboid intercostal nerve block, serratus anterior plane block, and paravertebral block on the postoperative quality of recovery and postoperative analgesia in modified radical mastectomy. A total of 132 breast cancer surgery patients were randomized 1:1:1 into three groups. 0.375% ropivacaine 20 ml for ultrasound-guided rhomboid intercostal nerve block group (n = 44), serratus anterior plane block group(n = 44), and paravertebral block group (n = 44). The primary outcome was the quality of the recovery-40 questionnaire (QoR-40 score).</p><p><strong>Results: </strong>The postoperative 24-hour QoR-40 scores of the rhomboid intercostal nerve block group (median: 186; interquartile range: 177, 190.5) and the paravertebral block group (median: 186.5; interquartile range: 176.25, 190.5) were not statistically significant. The serratus anterior plane block group (median: 168; interquartile range: 163.25, 172) had significantly lower QoR-40 scores than the paravertebral block group (median difference: -17, 95%CI: -20, -13; P < 0.001). Furthermore, the rhomboid intercostal nerve block group had significantly higher global QoR-40 scores than the serratus anterior plane block group (median difference: 17, 95%CI: 14, 20; P < 0.001). In addition, the intraoperative sufentanil consumption (P < 0.001), number of intraoperative sufentanil users (P < 0.001), and postintubation NRS scores (P = 0.01) of the rhomboid intercostal nerve block and paravertebral block group were significantly lower than those of the serratus plane block group, but there was no statistically significant difference between the rhomboid intercostal nerve block and paravertebral block group. There was no statistically significant difference between the three groups in postoperative numerical rating scale scores, postoperative tramadol consumption, adverse events, and average length of stay.</p><p><strong>Conclusion: </strong>Rhomboid intercostal nerve block and paravertebral block were able to provide similar analgesic effects and QoR-40 scores in breast cancer surgery. However, the blocking effect of the serratus anterior plane block was inferior to the rhomboid intercostal nerve block and paravertebral block. Rhomboid intercostal nerve block may be one of the best alternatives to paravertebral block as a fascial plane block.</p><p><strong>Trial registry: </strong>Chinese Clinical Trial Registry ChiCTR2300079196. Registered on 27 December, 2023.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"184"},"PeriodicalIF":2.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective in-depth analysis of anaesthetic management of spontaneous ventilation VATS for lung cancer resection: a matched pairs comparison to intubated VATS.","authors":"Lorenz L Mihatsch, Anastasia Huber, Sandra Weiland, Patrick Friederich","doi":"10.1186/s12871-025-03027-9","DOIUrl":"https://doi.org/10.1186/s12871-025-03027-9","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous ventilation video-assisted thoracoscopic surgery (SV-VATS) has been propagated for nearly two decades without a prospective in-depth analysis of anaesthetic management and anaesthetic processing times. This would be important as anaesthetic management of SV-VATS imposes fundamental changes to standards in thoracic anaesthesia and may increase anaesthetic risks. Therefore, this study aimed to provide such in-depth analysis and compare the results to data from matched intubated VATS (I-VATS) patients. 3D-reconstruction of bronchial airways helped to estimate the risk reduction by avoiding double-lumen tube (DLT) intubation according to common selection methods in SV-VATS patients.</p><p><strong>Methods: </strong>SV-VATS patients receiving anatomical (N = 22) and non-anatomical (N = 16) lung cancer resections were prospectively enrolled. A retrospective I-VATS control cohort (N = 76) allowed for a 2:1 propensity score matching. DLT sizes necessary for SV-VATS patients according to common selection methods were evaluated by 3D-reconstruction of the left main bronchus and the ≥ 1 mm criterion.</p><p><strong>Results: </strong>SV-VATS patients required substantially less propofol dosage (P < 0.001) with an increase in variability of drug dosing (P < 0.001) and higher BIS values (P < 0.001) as compared to I-VATS patients. SV-VATS lead to higher variability in respiratory parameters (P < 0.001) with less driving pressure (P < 0.001) and similar mean tidal volumes, oxygenation, and hemodynamic parameters compared to I-VATS. Spontaneous ventilation was achieved by allowing for permissive hypercapnia and respiratory acidosis. Anaesthetic processing time was reduced by 7 min (P < 0.001). 5-10% of female and 5% of male patients would have received a DLT larger than their bronchial airway.</p><p><strong>Conclusions: </strong>Our study provides the first prospective quantitative in-depth analysis of a standardised anaesthetic management regime for SV-VATS, including anaesthetic processing times. Respiratory parameters during SV-VATS are compatible with reduced mechanical power as compared to patients undergoing I-VATS. The anaesthetic management regime reduced the risk of airway damage imposed by choosing too-large DLTs in up to 10% of patients without compromising oxygenation and hemodynamic stability. Changes in anaesthetic processing time by 7 min would not allow for a higher caseload of SV-VATS for lung cancer surgery.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"185"},"PeriodicalIF":2.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the commment of changes of endotracheal tube cuff pressure and its indicators in laparoscopic resection of colorectal neoplasms: an observational prospective clinical trial: BMC anesthesiology. 2024 Nov 13;24(1):413.","authors":"Xuan Wang, Shenquan Cai, Jie Zhang, Guangli Zhu, Chenyao Jian, Shanwu Feng, Manlin Duan","doi":"10.1186/s12871-025-03057-3","DOIUrl":"https://doi.org/10.1186/s12871-025-03057-3","url":null,"abstract":"<p><p>We sincerely appreciate the valuable comments from the readers, which provide insightful feedback to help us improve our future work. We acknowledge that multiple factors can influence tracheal tube cuff pressure, and we have carefully considered the suggestions provided. Regarding the peritoneal insufflation pressures, these values in different time points had no significant difference as reported in our previous manuscript.Clinical trial number: ChiCTR2100054089. URL: https://www.chictr.org.cn/edit.aspx?pid=142785&htm=4 , Principal investigator: Manlin Duan, Date: 08/12/2021.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"183"},"PeriodicalIF":2.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}